Case-control study- Analyzes and OUTCOME and looks back in time to assess exposure

A cross-sectional study is used to assess disease status and risk factors at 1 point in time and are used to study
disease incidence and prevalence.

A randomized controlled trial refers to a study where a group is given a treatment and outcomes are compared
against a control group given a placebo or treated with the standard of care.

A meta-analysis provides a statistical analysis of the results of multiple studies.

A Cohort study follows a group of similar individuals WITHOUT a disease over time to determine the risk of
developing the disease

Multiple Choice Responses

A. Cross-sectional study
B. Randomized controlled trial
C. Meta-analysis
D. Case-control study

-Syphilis can induce symptoms similar to mania

-Lead Poisoning can cause symptoms like ADHD
-Descriptive Statistics  Numbers and Graphs -Inferential Stats  Testing a hypothesis

MEDICARE:
-Medicare Part A covers hospital care, meds in acute care setting, SNF, hospice
-Medicare Part B covers doctor visits, lab tests, diagnostic screenings, medical equipment, ambulance
transportation and other outpatient services.
-Medicare Part C covers vision, dental, HMO, PPO
-Medicare Part D covers prescription costs

-Clonidine needs to be tapered off

-Minimum duration to dx hypomanic episode is 4 days, 1 week for manic

-Women with opioid dependency; DBT is recommended

-Verinicline is Chantix

-Abulia Is lack of motivation, initiative or will. Can’t act or make decisions on their own.
-Anhedonia is inability to experience pleasure
-Alogia is lack of unprompted speech
-Avolition is lack of interest or drive to perform self-directed activities

-Nystagmus  PCP need benzo to treat

-Dilated Pupils, HTN, insomnia, sweating, cramps, myalgia  opioid withdrawal

1
-No medications are FDA approved for ODD

-Stool softeners are permissible for anorexic patients; docusate

-Acomprosate is an anti-craving drug used for maintenance of alcohol withdrawal

-Buprenorphine (SUBUTEX) for maintenance for therapy in opioid withdrawal

-SSRI can increase anxiety symptoms for first few weeks of treatment

-Bruxism is excessive teeth grinding

-Affordable care act allows up to 26 years of age to be under parent

-Kava Kava may help with adjustment disorder

-Clozapine levels can be significantly lowered by cigarettes which is high potent inducer of P450

-3 non-overlying symptoms needed for “mixed” features

-Gender identity starts at 18-24 months

-Therapies for depressive disorder: IPT and CBT

-Wisconsin card sorting test is best to assess EXECUTIVE FUNCTIONING

-Separation anxiety is commonly seen at 10-18 months of age; stranger anxiety at 8 months

-Beta blockers can help with akathisia

-Mean onset of schizophrenia 20-28 years in males, 26-32 in females

-Prader Willi Syndrome – Deletion of chromosome 15, obesity, hyperphagia, short stature, hypogonadism

-Childhood onset fluency disorder is STUTTERING

-Sunset Legislation – An act must be reviewed by a certain date or it will be automatically rescinded

-Sunshine Legislation – legislation designed to increase transparency in government processes

-Enzyme inhibition is faster than enzyme induction

-In psychodynamic therapy, “working through” involves the therapists helping patient find patterns of defensive
mechanisms and object relations

-Person on PCP, risk for rhabodymylosis

-SSRI’s can increase risk of bleeding due to interactions with serotonergic receptors on platelets

-SIADH commonly occurs with Prozac; also CNS activation as well (anxiety, restlessness, tremors, insomnia)
2
-Buprenorphine vs naloxone vs naltrexone; naloxone can block effects of buprenorphine when injected

-Topiramate side effect can be kidney stones; ETOH is CYP450 inhibitor can help induce renal stones

-St. John’s Wort used for depression, MAY CAUSE CYP INDUCTION lowering the level of many drugs
including warfarin and digoxin. ALSO ACTS AS SRI, so should be avoided in serotonin raising medications
such as MAOI’s and SSRI’s due to risk for serotonin syndrome.

-Mood stabilizers are typically restarted on second semester; avoided on first. ECT okay for pregnancy as well.

-First generation antipsychotics can be used during pregnancy.

-Fetal Alcohol Syndrome (FAS) wide-set eyes, short palpebral fissure, short and broad bridged nose,
hypoplastic philtrum, thinned upper lip, flattened mid-face

-Benzo Intoxication:
Usually when regimen is initiated; drowsiness, psychomotor impairment, or memory impairment. Agitation,
confusion, drowsiness, blurred vision and dizziness as mild symptoms.

-Benzo withdrawal:
-anxiety, tremors, nightmares, N/V, anorexia, insomnia, postural hypotension, seizures, delirium, hyperpyrexia.

-AA focuses on development of spirituality

-Negative Contrast: Switch from high to low rewards can weaken behavior
-Partial reinforcement extinction effect: paradoxical event where rewards can sometimes weaken behavior
while non-rewards strengthen it
-Reinforce devaluation: Subject decides previous reward is no longer valued
-Extinction: Loss of previously learned operant response after it is no longer reinforced by a stimulus

-Carbamezapine has risk for bone marrow suppression, aplastic anemia, thrombocytopenia, agranulocytosis; can
occur very quickly

-Systemic Lupus Erythematous can cause psychosis

-CEREBRAL CORTEX: Sensory and Motor functions

-PONS: Relays signals between cerebrum and cerebellum; CN V-VIII originate here
-CEREBELLUM: coordinates body movement, balance, coordination
-MEDULLA: Located in Brain Stem; controls respiration and ventilation

-Methamphetamine: Leads to meth-mouth aka xerostomia

-TCA lowers seizure threshold too; like Clomipramine

-Ziprasidone (Geodon) is absorbed more quickly after taking within 1 hour of a meal; fatty meal increases
absorption. TD also occurs in lower rates with Geodon. DM isn’t a side effect.

-MAUDSLEY MODEL: family based therapy for anorexia nervosa up to 19 years old

3
-ARBITRARY INFERENCE: Coming to incorrect conclusion based on a previous experience
-SELECTIVE ABSTRACTION: taking a small detail out of context to make an entire experience negative

-BUSPAR can be used for patient with respiratory issues; no respiratory depression.

Effexor can lead to interstitial lung disease

-Lithium has been associated with ACNE

-CLOZAPINE: Neutropenia, eosinophilic colitis, myocarditis
-Depakote: Rare is pancreatitis

-2 years: PARALLEL PLAY

-3 years: ASSOCIATED PLAY
-4 years: COOPERATIVE PLAY

->75% schizophrenic patient relapse within 5 years after discontinued treatment after initial treatment

-COHORT STUDY: Examines a group of individuals with one or more common characteristics
-RANDOMIZED CONTROLLED TRIAL: Recruit research subjects who are assigned to an intervention and
control group. Data are numerical and evaluated using rigorous statistical testing.
-EXPERIMENTAL DESIGN: “Gold Standard”
-QUASI-EXPERIMENTAL DESIGN: Similar to experimental design, but there is no randomization of
subjects. Research subjects recruited by convenience sampling.

-To test for Systemic Lupus, antinuclear antibody is used for testing

-Duty, Deviation, Damages and direct involvement required for a malpractice suit (4 D’s)

-Flumazenil used for benzo overdose

-Paxil can present risk for fetal heart defects in first trimester

-For schizophrenia, CBT is standard psychotherapy

-Botulinum Toxin (Botox) is injected into glabellar region to reduce frowns; helped with depression

-Carbamezapine, neutropenia can occur often. Blocks sodium channels

-PTSD rate for Native Americans 3 times the national average

-Latinos face more higher rates than African americans as combat vets

-Psychosis induced polydipsia; polydipsia and water intoxication are associated with heavy cigarette use.
Nicotine induces release of ADH which fuels thirst.

-Abreaction: Occurs when repressed memory and assoc. effect is brought into consciousness
-Defense Mechanism: conflict between opposing wishes or between wishes and prohibitions

4
-Neurosis: Unconscious intrapsychic process that regulates basic biologic drives and maintains psychological
homeostasis
-Reality Principle: Concept that people seek to avoid pain and discomfort and strive for gratification and
pleasure

-Clomipramine (TCA) is FDA approved to treat OCD

-Buproprion is an inhibitor of CYP450; will make other medications increase

-GINKGO BILOBA: Helps with blood flow, cognitive enhancement

-Echinacea Purpuria: Helps with inflammation
-Ginseng: Helps with mental and physical performance
-Allium Sativum: (Garlic) can have antiplatelet effects, mild cholesterol lowering
-KAVA KAVA: Sedation, anesthetic properties

-INDUCTIVE REASONING: Developing generalizations from specific observations

-DEDUCTIVE REASONING: Develop specific predictions from set of principles

-Sertraline is CYP450 Inhibitor; will increase level of other meds

-Persecutory type is the most common delusional disorder

-Sjrogrens Syndrome: Gritty eyes, dry mouth, enlarged parotid gland. Can do anti nuclear body testing (ANA)

-Xyrem is used for cataplexy narcolepsy

-Most bipolar disorder onset is from 15-19 years of age and 20-24

-POSITIVE REINFORCEMENT: Adding Desirable stimulus to increase specific behavior

-NEGATRIVE REINFORCEMENT: Removal of undesirable stimulus to increase specific behavior
-POSITIVE PUNISHMENT: Addition of undesirable stimulus to reduce specific behavior
-NEGATIVE PUNISHMENT: removal of desirable stimulus to reduce a specific behavior

-TIME OF EXPOSURE is altered for ECT, not the ampere dose

-Hippocampal volume decreased in schizophrenia; NOT ATROPHY

-Mothers of patients with anorexia may have OCD

-Panic disorder typical age onset is EARLY ADULTHOOD

-Cannabis works like opiates, nicotine and cocaine as it causes dopamine release in the mesolimbic system

-LSD is serotonin agonist

-False positive for methamphetamine: MAOI Like selegiline; fluoxetine, trazodone, chlorpromazine, Wellbutrin

-Pediatric patient have HIGHER METABOLIC CAPACITY, more and faster renal elimination, greater volume
of extracellular water, lower content of adipose tissue
5
-Psychotherapy notes are kept separate from billing and medical notes

-Lithium showed to reduce suicidality rate for UNIPOLAR AND BIPOLAR depression

-Clozapine showed to reduce suicidality rate in schizophrenia or schizoaffective disorders

-Marinol (dronabinal) is man-made cannabis FDA approved for anorexia in AIDS

-Atomoxetine inhibits
/BLOCKS reuptake of NE ONLYYYY

-Less than or = to 40% of patients on maintenance therapy for schizophrenia will relapse each year

-PTSD prevalence higher in women than men; can develop PTSD without developing ASD

-Martha Rogers criticized NP role

-TRANS THEORETICAL CHANGE MODEL

1. Precontemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance
6. Termination

-INFANTS of depressed mothers exhibit MORE fussiness, less facial expression, less head orientation, less
crying

-People with PROFOUND Intellectual Disability have sensorimotor impairment and an identifiable neurologic
condition

-Clinical Decision Support System (CDSS)

-Sampling bias occurs when recruiting VOLUNTEERS

-EXPECTANCY BIAS: When researcher knows which patient is distributed to each group. Random reduced
by double blind study
-Selection BIAS: occurs when there is a systemic difference in the method of choosing study groups. Bias
reduced by randomization
-PROFICIENCY Bias: when treatments administered at different sites are compared if a site has greater
proficiency in the administration of the treatment or intervention

-Take blood test level for LITHIUM 12 hours after administration

-DURATION OF CONINTUOUS ECT IS 10 weeks, if successful taper to monthly to 3 months. If in remission,

6 months after remission for maintenance

-Ratio refers to “RESPONSE”; interval refers to “TIME”

-STUDENTS T-TEST: Compare the means of 2 independent sample populations

6
-PAIRED T-TEST: Used to compare the means of 2 related (pairs) sample populations. Example is a twin
study.
-Z-TEST: Similar to t-test but requires either a large sample or a known population variance
-CHI-SQUARE: Used to compare non measurable/nominal categorical variances

-Lithium can cause polyuria due to decreased reabsorption of fluid from distal tubules of kidneys. Amiloride
can help with polyuria

-CLOZAPINE:
a. TD is NOT a high-risk s/e
b. Agranulocytosis can occur mostly within 6 months of treatment; more likely in women, advanced age, or
Ashkenazi Jew
c. Seizure, wt. gain, metabolic changes are possible

-Cultural practices outweigh diagnosis

-Modanafil is FDA approved for excessive sleepiness associated with narcolepsy, sleep apnea, shift work
disorder

-SSRI first line for kleptomania

-AA holds that chronic alcohol disorder is lifelong, IRREVERSIBLE; long term fellowship is essential for
sobriety

-Positive vs negative predictive values

-Plan Do Study Act (PDSA): Scientific Model of improvement by “Institute of Healthcare Improvement” to
accelerate quality care for patients

-SWOT is Strengths, weakness, opportunities, threats

-HITECH is health information technology for economic and clinical health act

-RETROGRADE AMNESIA is common S/e of ECT; severe amnesia during the ECT course can be managed
by increasing the interval between treatments, changing ETC type or, if necessary ending treatment. Retrograde
amnesia is more prominent with ECT use. This deficit is greatest for more recent memories. Increasing the
interval between treatments or changing ECT type from bilateral to unilateral electrode placement can manage
SEVERE amnesia

-P-Value in stats; chance that something can happen by chance if null hypothesis is true

-Narcissistic and BPD share CORE borderling personality organization

-CBT used for OCPD

-NALTREXONE; used for opioid addition and ETOH dependence. 50 mg. Antagonize opioid rec.
-ACAMPROSATE (Campral): Resembles GABA; antagonize NMDA, used for ETOH dependence,
maintenance
-DISULFIRAM (Antabuse): Aldehyde Dehydrogenase INHIBITOR

7
-Paliperidone is Invega, metabolite of Risperdal. No known advantages over it.

-Epstein bar from lithium: Tricuspid valve defects

-Catatonic Syndrome: excitement, immobility/stupor (Extreme signs), withdrawal (Refusal to eat drink make
eye contact), catalepsy, echopraxia, echolalia, etc

-Negative/Positivie Emotionaliaty, Constraint, Temperament

-Fluoxetine mixed with “L Tryptophan” can cause serotonin syndrome

-Nefazodone is Serzone, antipsychotic is a CYP inhibitor

-Negative symptoms can be secondary to drugs

-FAY AVDELLAH developed 21 nursing problems; emphasizes delivery of nursing care for the whole person t
meet the physical social emotional intellectual and spiritual needs of the client and family
-NIGHTINGALE viewed role of nurse as provider of fresh air, light, cleanliness, warmth, qiet nutrition
-Leininger developed the theory of culture care
-Rogers: Described the individual as an energy field existing within the universe

-ACCORDING TO WHO: Depression is the leading cause of disability worldwide

-Formulation  Implementaion  Evaluation

-THIAMINE is deficient in Wernicke’s encephalopathy and Korsakoff Syndrome; MRI scan in Korsakoff’s
Syndrome include midbrain, pons, hypothalamus, thalamus, cerebellum, mammillary bodies, diencephalon

-Coenzyme Q10 (CoQ10) lower in people with Parkinson’s

-Clomipramine (TCA) can be used for OCD

-Elevated prolactin assoc. with increased bone demineralization, osteopenia, osteoporosis

-Overall fetal malformation with SSRI’s is 2.6%

-ECT is most effective of all treatments for major depression according to controlled trials over MAOI’s, SSRI,
TCA

-Cyclothymia requires two years for diagnosis for adults, 1 year for children and adolescents; hypomanic and
depressive symptoms

-Hallmark symptoms of Vitamin B12 deficiency is Megaloblastic anemia, assoc. with neurodegenerative
changes of the central and peripheral nervous systems. Can occur with alcohol abuse, lack of intrinsic factor in
the gut from gastrectomy, pernicious anemia

-Paxil has no FDA approved indications for children or adolescents

-Occasional cross eyes normal up to 2 months of age for infants

8
-Acute Angle Closure Glaucoma: sudden onset of HA, Eye pain, tearing, N/V, halos, Fixed Pupil, Excessive
tearing, Conjunctival injection. Due to blockage of aqueous humor resulting in marked increase of IOP.

-Wenicke’s Encephalopathy presents with neurological symptoms caused by biochemical lesions o the CNS
after exhausting thiamine Vitamin B1. S/s include opthalmoplegia, ataxia, confusion, hypothermia,
hypotension, peripheral neuropathy, weakness, amnesia, hyperhidrosis, foot drop and decreased proprioception

-Korsakoff’s syndrome usually presents with amnesia, confabulation and apathy

-Delirium tremens: Rapid onset of confusion, NO foot weakness and foot drop.

-Valproic Acid is more effective than lithium in patients with prominent depressive symptoms during mania,
with mixed symptoms, multiple mood episodes

-Lifetime prevalence of anxiety is 25-35%

-Disinhibited social engagement disorder; reduced or absent reticence in approaching and interacting with
unfamiliar adults, overly familiar verbal or physical behavior not consistent with culturally sanctioned/age-
appropriate social boundaries, diminished or absent checking with an adult caregiver after venturing away an;
more so due to experiencing insufficient cared willingness to go off with an unfamiliar adult with minimal or no
hesitation. No Hx of impulsivity or TRAUMA.

-In COMBINE research study, naltrexone effectively delayed time to relapse compared to placebo.
Acamprosate fared poorly compared to various combos with naltrexone and CBI

-Analysis of variance (ANOVA) used to compare the means of multiple groups to determine if all are equal,
thereby generalizing the 2-sample t-test to several groups.

-Student T-TEST is used to compare the means of 2 independent sample populations

-Paired T-Test is used to compare the means of 2 related sample populations; ex. Measuring a disease metric in
the same population before and after a treatment.

-Z-tesat is similar to T-test but requires aeither a very large sample or a known population variance.

-triazolam (HALCION) 1.5-5.5 ½ life

-diazepam (Valium) 20-50 hours
-chlordiazepoxide (Librium) 24-48 hours
-flurazepam (Dalmane) 24-100 hours

-ECT first used in 1940s

-ATYPICAL MARKERS OF MAJOR DEPRESSION INCLUDE: interpersonal rejection sensitivity, appetite

increase, marked mood reactivity, leaden paralysis, weight gain; more common in women. MAOI’s effective
for atypical depressive symptoms

-In Schizophrenia
a. Decreased ACH in frontal love with cognitive decline
b. Increase NE in reward circuits linked with anhedonia
9
c. increased Serotonin linked with positive and negative symptoms
d. increased dopamine linked with positive symptoms

-With partial seizure 40% have normal EEG; derived from deep limbic brain structures, most commonly
temporal lobe

-50% of epileptic patients experience depression

-“BARGAINING” phase, think “if, then” scenarios

-Selegiline MAOI PATCH bypasses gastric tract so no need to avoid tyramine in diet*

-Hypothyroidism carries high risk for carpel tunnel????

-Transcranial magnetic stimulation (TMS) useful for HALLUCINATIONS

-Hyperthyroidism may manifest like GAD or panic disorder

-Successful malingerers more likely to report less symptoms, and more common symptoms

-Dissociative amnesia includes loss of autobiographical memory, sometime with preserved ability for new
learning

-Wenicke’s encephalopathy results from vitamin B1, thiamine deficiency, in malnourishment such as in chronic
alcohol use disorder. Triad is confusion, ataxia and ophthalmoplegia.
-Korsakoff’s disease is the CHRONIC phase of thiamine deficiency, presents with anterograde and retrograde
amnesia; classically confabulation and result of poor memory

-Transient GLOBAL amnesia leads to anterograde amnesia, the inability to encode new memories and
immediate recall as well as remote memory. Neuro exam normal.

-Ventricular arrhytmia and seizures can occur from TCA overdose. TCA’s assoc with increased risk for MI
compared to SSRI’s. They are structurally similar to class I antiarrhytmics that are actual proarrhytmic in 20%
of the population

-Somatic disorder more frequent in people with lower levels of education and socioeconomic status

-Studies suggest that ADHD is present in most cultures 9-12% school age children

-Varenicline (Chantix)is a water soluble agonist at the alpha 4 beta 2 of nicotinic receptor, competitively
inhibits nicotine; also has some affinity to serotonin receptors

-no washout period needed when changing same class of medication to another; SSRI to another SSRi

-Lower Lipophilicity leads to more time in the brain and body

-Carbamazepine, Valproic Acid, Phenytoin safe for breast feeding

-BENZO, Lithium Lamotrigine not safe for BREAST FEEDING

10
Schedule I drugs: Heroin, LSD, Marijuana
Schedule II: Hydrocodone, oxycodone, pentobarbital
Schedule III: anabolic steroids ketamine’s, narcotics, buprenorphine
Schedule IV: benzos
Schedule V

-Quetiapine approved FDA for bipolar depression; also, olanzapine and fluoxetine in combination and
lurasidone

Valporoic FDA approved for acute mania and mixed episodes

-Lamictal is FDA approved for MAINTENANCE of bipolar I

_Abilify approved for FDA: acute mania, mixed mania for ages 10 and older as monotherapy or adjunct

-Ramelteon is synthetic agonist for melatonin MT1 and MT2 receptors; higher affinity than endogenous
melatonin

-Limbic system key area for smell and emotion

-Occipital lobe key for visual functions

-Frontal lobe key for executive function, social conduct, judgment, insight, motor function

-Parietal lobes are key areas for sensory integration and somatosensory fxn

-Reliability is the overall consistency of a measure

-Validity: Measurement of How well it addresses the purpose chosen by the user and is a function of how the
measure is built

-SENSITIVITY: Ability of a test to correctly identify those with the disease (TRUE POSITIVE RATE)
-SPECIFICITY: Ability of the test to correctly identify those without the disease (TRUE NEGATIVE RATE)

-TWO BIOMARKERS sensitive for HEAVY chronic ETOH Use is GGT and CDT

-Donepezil (Aricept) common SE is GI upset. It is an acetylcholinesterase inhibitor.

-Barbituates lower Plasma TCA levels

-Paraphilias are almost never diagnosed in females.

-DEPAKORE most likely to cause teratogenic effects on 3-8 weeks pregnancy

-Native American highest risk of developing social phobia

-Social phobia higher risk in young people and females and Native Americans

-CONTRACTED SERVICE SYSTEM: NP signs a contract and agrees to provide care for a specific population
-A SECOND PARTY SYSTEM: payments through a legal guardian or guarantor
11
-THIRD PARTY PAYMENT: payment by Medicare, Medicaid and Private Insurance
-FREE for SERVICE: Patient pays directly

-DESCRIPTIVE STUDIES are MEASURABLE, NUMERICAL, EVALUTED STATISTICALLY, but no

NOT possible to PROVE causation with a descriptive study

-Accuracy = (True Positive + True Negative) / Entire Population

-Precision is the degree to which repeated measurements under unchanged conditions show the same results =
(True Positives)/(All Positives)
-Specificity is the probability the test will be negative among those who do not have the disease= (True
Negatives)/(False Positives + True Negatives)
-Sensitivity is the probability that the test will be positive among those who have the disease = (True Positive) /
(true positive + false negative)

-Personality disorders have four areas

1. Cognition
2. Affectivity
3. Interpersonal Functioning
4. Impulse Control

-Carbamazepine slows cardiac conduction and should be avoided in patient with high grade AV block and Sick
Sinus Syndrome

-Schizophrenia affects 1% of population worldwide; sensory gating is the ability to suppress information;
people with schiz. Are often part of various endophenotypes that process these stimuli abnormally which may
contribute to the disease

-Duloxetine FDA approved for diabetic peripheral neuropathy

-Classical Conditioning; a conditioned stimulus elicits a conditioned response due to proximity to an

unconditioned stimulus and unconditioned response
-OPERANT CONDITIONING: when a reinforcement or punishment is used to modulate the FREQUENCY of
a particular behavior
-COINCIDENAL LEARNING: takes place secondary to the unexpected consequences of behavior; not a
learning modality though

-ACAMPROSATE IS STRUCTURALLY resemblent of GABA

-PTSD common comorbid with Major depression

-Dissociative identity disorder commonly occurs with comorbid psychiatric conditions

-Phenothiazine (Compazine, Phenotil, Prochlorperazine) SELDOM used for psychosis. It has prominent
antiemetic/antivertigo activity for short term nausea, vomiting, vertigo.

-transitional objects in children are physical reminders of a mother’s presence; usually surrender them by age 5
with variation

-cyclothymia 1 year for children/adolescents; 2 years for adults

12
-SELF-SYSTEM describes a stable and realistic sense of self.

-ILLNESS ANXIETY disorder, individual performs excessive health-related behaviors or maladaptive

avoidance

-Patients presenting with dementia; paraneoplastic limbi encephalitis should be suspected

-DRG (diagnosis related groups) are groups r/t a diagnosis with a fixed reimbursement amount; adjustments are
based upon severity of the case teaching costs and area of service.

-Xyrem AKA sodium oxybate is approved by FDA for EDS and cataplexy assoc. with narcolepsy

-Reactive attachment disorder: Repeated changes in caregiver, Hx of neglect, avoidance of social interaction,
resistance to comforting from others

-Disinhibited social engagement disorder presents with excessive indiscriminate sociability and lack of
selectivity in attachment figures

-HAWTHRONE EFFECT: Study participants change their behavior for no other reason except the knowledge
that they are being studied
-SIMPSON”S PARADOX: 2 studies with similar correlations can be combined to exhibit the opposite trend
-NOVELTY EFFECT: individual responds most strongly to a seemingly dangerous experience when faced with
it for the first time (roller coster, bungee jump); the novelty effect wears off over time.
-THE PYGMALION EFFECT: People tend to perform to the expectations placed on them

-ECT causes genewralized tonic-clonic seizures by using alternating current electrical pulses via scalp
electrodes under general anesthesia.

-Null hypothesis states that chance alone could be the case of the results obtained in the study.

-A fixed ratio schedule provides reinforcement every set number of RESPONSES

-A Fixed interval schedule provides reinforcement for a response that occurs after a set time
-A variable interval schedule provides reinforcement for responses that occur after varying amounts of time

INTERVAL BASED ON TIME; RATIO based on RESPONSES

-Maladaptive gambling b3havior; needs 4/9 criteria

-Duloxetine increases hepatic transaminases and may further increase levels in patients with chronic liver
disease, cirrhosis, heavy drinking; half life longer than Effexor. Discontinuation syndrome less likely because of
this, fewer sexual side effects, no affinity for histaminic or cholinergic receptors, sedation, weight gain,
anticholinergic effects

-Antipsychotics can worsen catatonia due to parkinsonian side effects and can increase risk for NMS; think of
ECT if catatonia presents

-SIRS used for malingering; score has to be in the definite range in a primary subscale or in the probable range
in 3 subscales for it to be positive.

13
-Adding HCTZ to lithium helps with polyuria

-MADELINE LEININGER: Theory of Culture Care

-KUBLER ROSS: Identified stages of grieiving
-ROSENTOCK STRETCHER and BECKER: Health Belief Model

-EDINBURGH depression scale designed for DEPRESSION I NPREGNANCY A DPOSTPARTUM PERIOD

-Litnium has INSULING LIKE EFFECT lowering BLOOD glucose and increasing appetite and weight gain

NEUTROPENIA MYOCARDITIS AND COLITIS assoc. with CLOZAPINE

-Fluoxetine or SSRI’s with TCA increase cardiac risk

-for patient with Parkinsons’s ECT can cause delirium

-SSRI’s can worsen parkinsonian tremors and decrease “off time”

-Naloxone BLOCKS effect of buprenorphine/opioids

-for many states child of 17 does NOT have to have parental consent for any pregnancy related care, but
ABORTION you do

-during termination phase, REGRESSION will occur first than self-management strategies and revewing
client’s progress toward objectives are also aspects of termination phase

-Max Methylphenidate is 60 mg; Focalin is 20 mg; focalin XR is 40 mg, Concerta is 72 mg max

-With stimulants, growth retardation and psychosis are UNCOMMON. Abdominal pain and anorexia are
COMMON

-SSRI’s can help to delay ejaculation

-Prozac, peak plasma concentration is delayed but no decreased.

-Zoloft increased 25%, Paxil 6% peak plasma concentration when taken with food

-Remeron, 1/1000 experience agranulocytosis; the most serious side effect; Hypotension and hyponatremia are
other risk factors. It causes urinary frequency and improves nausea and vomiting due to 5-HT3 blockade

-Minors have the right to decline contraceptives, abortion, prenatal care, drug, alcohol, mental health services
regardless of intellectual disability

-CONCORDANCE susually means the presence of the same trait in both members of a pair of twins

-BUSPAR acts on 5-HT1A receptor partial agonist at postsynaptic receptors

-For PMS, combined estrogen-progestin oral contraceptive, gonadotropoin releasing hormone agonists and
SSRI’s are the 2 most common ways to treat PMDD

14
-MEDS to be STOPPED for ECT: Theophylline, LITHIUM Benzos and ANTICONVULSANTS. Flumazenil
given if Benzo can’t be held or withdrawn or reduced

-Congenital adrenal hyperplasia, which is assoc. with increased prenatal androgen exposure has been linked to
higher rates of homosexuality in affected females.

-Dopamine is thought to mediate social interest, gregariousness, confidence and sensitivity to rejection; assoc.
with social phobia. Serotonin and NE as well.

-spironolactone given for hirsustism

-ECT safe for pregnancy for severe psychosis; most common s/e is HA with possible short term amnesia

-Accommodation: Lose-Win Situation

-Avoidance: Lose-Lose Situation
-Compromise- Lose Lose situation
-Competition: Win-Lose Situation

-HALO Effect: occus when a researcher’s evaluation of a subject’s current performance is altered based on his
or her opinion of the previous performance of the subject

-Absorption and transportation of drugs become comparable between children and adults at 4 months***

-Xanax 1 mg is = Ativan 2 mg

-TMS may be effective to treat depression and anxiety: place electromagnetic coil on scalp and running
electricity through it; magnetic field enters the neurons. Used for anxiety, depression, pain, schizophrenia and
hallucinations

-Deontology is a theory based on the works of Immanuel kant and is the root of many religious conditions; it
holds that an actions ethicality is based on the intent.

-HAM-D Depression scale (HAMILTON DEPRESSION RATING SCALE) and the Montgomery Asbert
Depression Rating Scale MADRS are the most commonly used scales in following TREATMENT RESPONSE.
HAM-D most commonly used in US antidepressant drug trials, Trials for ECT and TMS.

-BPRS (Brief Psychiatric Rating Scale) used to measure psychiatric symptoms such as depression, anxiety,
hallucinations and unusual behavior

-Lithium and SSRI’s have been useful for KLEPTOMANIA

-Remeron is a TETRACYCLIC (not tricyclic)

-Schizophrenics have enlarged cerebral ventricles and decreased brain volume

-LOCALIZED AMNESIA: Lack of memories from a circumscribed period of time, usually immediately
following a traumatic event
-SYSTEMATIZED AMNESIA: Loss of memory r/t a particular category of information
-GENERALIZED AMNESIA: Lack of memory of the patient;s ENTIRE life
-SELECTIVE AMNESIA: Recall some but not all events at a particular time
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-PANIC ATTACKS:
Fear triggers amygdala that activates the sympathetic nervous system and the hypothalamic pituitary adrenal
axis. SNS activates the locus coeruleus and adrenal medulla, increasing epinephrine and norepinephrine. The
locus coeruleus is a nucleus in the pons of the bvrainstem and nproduces norepinephrine. The HPA axis releases
corticotropin releasing factor, activating ACTH causing secreation of cortisol. Catecholamines such as
epinephrine and NE are released from the adrenal medulla.

-Venlfaxine 5% excreted in urine

-Fluoxetine <10% unchanged in urine

-Phenelzine is and MAOI can be used for social anxiety disorder

-Names of all clinics where NP practices if the practice has multiple clinics MUST be on prescription

-Depression is number one psychiatric cause of disability in the world

-Estimated 20% of zdults in the US have a mental illness in a given year
-According to the WHO, mental disorders are the SECOND most disabling category of illness around the world

-TCA’s toxicity include CONVULSIONS and COMA

-CLOZAPINE S/e’s:
->ALPHA-1 blockade: Dizziness, sedation, hypotension
->D2 Blockade: Motor s/s
->Muscarinic 1 Blockade: Dry mouth, constipation,
->Histamine Blockade: Sedation, weight gain.
->OD leads to delirium, lethargy, tachycardia, hypotension, respiratory failure.
->Hypersalivation in 33%, myocarditis is rare, hepatotoxicity is very rare.

-PTSD requires 4 or more of physical symptoms for diagnosis x 1 month

-Women of childbearing age receive B-9 folate who are treated with Depakote

-social anxiety disorder can be diagnosed at any age; s/s atleast 6 months

-GABAPENTIN:
a. somnolence and dizzimness are common s/e’s
b. NOT metabolized in liver
c. Doesn’t interact with anticonvulsants
d. No inhibition of cytochrome P450 Enzymes

-Infant plasma levels are considerably higher for doxepin than for other TCAs

-Emergency Medical Treatment and Labor Act (EMTALA) is a law that requires most hospital to provide an
exam and needed stabilizing treatment without consideration of isnruance coverage

-SAMPLING:
a. Stratified sampling: proportion of the study population belonging to each group of interest is known.
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b. Cluster sampling: selection of the groups under study is random; rather than the eselection of study units.
Clusters often geographic or organizational units

c. Systemic sampling refers to choosing individuals at a regular intervals froma sampling frame by selecting a
number to determine where to begin selecting individual subjects

d. Simple Random Sampling: making a numbered list of all units in a population from which you want to draw
a sample, deciding on the sample size and selecting the required number of sampling units using a table of
random numbers or a lottery method

-Taking Methotrexate while on Clozapine can risk for more leukopenia, reduction of wbc

-HEALTHY PEOPLE 2020: reduce suicide rate and attempts by adolescents, eating dirosoders,

-Clozapine: Sialorrhea, (hypersalivation and drooling) is a common s/e

-Depakote increases levels of GABA, block voltage dependent na channels, inc

-Lithium has risks for hyperplasia and adenomas of the parathyroid glands leading to
HYPERPARATHYROIDISM and HYPERCALCEMIA

-Carbamezapine inhibits voltage dependent sodium channels, presynaptic sodium channels, inhibits glutamate

-Isoniazid can cause mania

-Lorazepam is good for alcohol detox; especially with pt.s with liver dysfunction

-Typical psychotic overdose: cardiac arrhytmias, hypotension and EPS

-Hypnotics are absorved more slowly when you have a full stomach; should be taken on empty stomach

-Cigarettes cause enzyme induction, increase metabolism of other drugs

-Yohimbine helps with SSRI induced sexual dysfunction

-Lisinopril, ACE and ARBS can increase levels of lithium

-Remeron is a tetracyclic: NE, SE

-Balanced Budget Act of 1997; Medicaid direct reimbursement to NP’s under federal law

-Duloxetine shown to reduce stress incontinence in women

-Modanafil promotes wakefulness by demonstrating histaminergic mechanism in addition to increasing

dopamine by binding to the dopamine transporter

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-Phenelzine is an MAOI; high risk for sexual side effects and weight gain

-Olanzapine has possible s/e of diabetic ketoacidosis; watch for Liver NOT renal

-Remeron has lease chance for sexual side effects because it blocks 5hT-2A; compared to TCA, SNRI, SSRI

-Wellbutrin can be stopped abruptly without s/e’s

-Correct format of the null hypothesis is there is no signficiant difference between the two groups

-Panic disorder is most commonly associated with agoraphobia

-Namenda is NMDA antagonist, not ach inhibitor

-Nefazodone (Serzone) has risk for liver failure

-Occurrence-based malpractice: covers past incidents

-Claims made policy: will need tail coverage

-Critical thinking is PATIENT DRIVEN

-FOR GAD, FDA approved meds: Paxil, Effexor, Celexa, Buspar, Lexapro Cymbalta

-DEPAKOTE Doubles half life of Lamictal(Increases Lamictal plasma amount)

-DEPAKOTE also LINKED To higher suicide risk by FDA
-Depakote check liver function every 6-12 months

-Specific gravity > 1.035 indicates dehydration

-HITECH Act contains provisions for “meaningful use” of health information tech.

-Warfarn does NOT increase free serotonin in body when taking SSRI;

-aldehyde dehydrogenase most studied gene for substance use disorder

-LITHIUM: S/e’s Tremor, polyuria, polydipsia, wt. gain, cognitive slowing, hypothyroidism, renal insufficiency

-Carbamazepine: sedation, dizziness, fatigue, nausea, ataxia, agranulocystois, aplastic anemia

-Discontinuation syndrome assoc. with SSRI’s and SNRI’s

-MAOI’s (selegiline) increase dopamine, TCA’s do not

-Cranberry and Kava Kava are inhibitors; grapefruit juice, grapes, pomegranate, mango, red peppers, green tea,
and vitamin E also inhibitors

-Seroquel used for OCD off label use

-Marijuana does not interact with SSRI’s

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-Dextromethorphan can increase serotonin levels; serotonin syndrome risk for SSRI’s

-Adenosine promotes NREM sleep. DA, Ach, NE promote wakefulness

-Paranoia, sc hizophrenia and substance use asre sall linked to the oral stage 0-18 months of life;
Failure of latency stage is the inability to form social relationships,
failure of phallic stage is sexual identity disorders,
failure of anal stage is depressive disorders

-Valproic acid increases GABA and blocks sodium channels

-Nortriptyline (TCA) still used in elderly

-SSRI’s CAN contribute to Parkinsonian tremors

-Atypical antipsychotics usually safe for pregnancy except Risperdal, which needs more study

-OLDER AMERICANS ACT (OAA) is established to provide improved access to services for older adults;
additional serviess for native American s inlcuidng community services
-EMTALA: Emergency Medical Treatment and Active Labor Act; designed to prevent patient dumping from
ER’s, premature discharge for economic reasons
-OMNIBUS BUDGET RECONCILIATION ACT: guidleines for nursing facilities as long-term care
-AMERICANS WITH DISABILITIES ACT (ADA): provides physically and mentally disabled patients access
to employment and community

-Anorexia Nervosa is closely linked with MDD

-Group therapy best for histrionic personality disorder, due to “attention seeking”

-MAOI’s like selegiline increase DA, NE, SE

-Antihypertensives cause ED and impaired vaginal lubrication secondary to antiadrenergic effects

-Antipsychotics cause ED, impaired lubrication, secondary to anticholinergic as well as alpha 2 receptor effects,
and cause impaired arousable and orgasme due to DA blocking

-MAOI-A metabolizes tyramine; not MAOI-B

-20% of bereaved individuals meet criteria for major depression

-PICO process is a process that was developed to assist in contruction of a searchable questions: who is the
patient population? Interest or intervention? Control group or comparison? Outcome?

-HPV not required to be reported by CDC; GC Syphllis, Lyme disease must be reported

-First line for treating bulimia is SSRI, fluoxetine is FDA approved. Paxil is not

-Criteria for Pedophilia: 6 mohnths of sexual urges, of 13 years or younger. 16 years of age or at least 5 years
older than the child sexually interested in

19
-NO FDA approved or children < 10 years old

-Atypical antispsychotics are used adjunctively for PTSD

-Oppositionality is common in age 2; don’t use for ODD Dx

-Hypercalcemia leads to delirium or personality change; hyperparathyroidism, renal stones,bone pain

-During depression, decreased slow wave sleep and Rapid Eye Movement latency decreased

-Methylphenidate doesn’t have significant metabolism through liver

-Schizophrenia, overall decreased brain volume

-Naltrexone is usually 50 mg a day, an opioid blocker

-Carbamezapine has risk for bone marrow suppression leading to agranulocytosis and aplastic anemia,
thrombocytopenia

-Antidepressants can worsen Parkinsons symptoms; lithium ma ybe used to have a neurprotectiove effect in
individuals with Parkinsons’s Selegiline has been effective in slowing progression of Parkinsons’s Disease by
unknown mechanism

-ORAL: Pranoia, schizophrenia

-ANAL: Depressive disorders
-PHALLIC: Sexual Identity Disorders
-Latency: Failure to form social relationshps

-PTSD most commonly assoc. with agoraphobia

-Dilated Pupils, think stimulant intoxication, LSD, Cocaine

-1/5 pt. with hyperthyroidism can have Psychotic symptoms

-Regression: Returning to a childlike state; refusing to engage, staying in bed

-Reaction Formation: Overcompensation; demonstrating opposite feelings
-Undoing: Cancel out emotions
-Displacement: Displacing feelings onto an uninvolved party
-Projection: Projecting personal undesired attributes onto someone who does not have those attributes

-NP billing “Incident to” for NP services requires physician to be present in the physical location or immediate
assistance

Nystagmus, think PCP

Valporate acid metabolized in liver

-Denial: Ignore a factual reality

-Rationalization: Use faulty logic to explain a situation
-Sublimation: Transform socially unacceptable impulse into a socially acceptable action or behavior
20
-Intellectualization: attempt to master current stressor or conflict by expansion of knowledge, explanation, or
impulse

-Long Term Potentiation: LTP leads to underlying memory formation

-Factor analysis; analyze group of variables. Covariance, analyze 2 variables

-Occurance based: covered anytime. Claims based, need tail ensurance

-Terbinafine is a CYP2D6 Inhibitor (potent)

-Projective identification in Personality disorder:

1. PT assigns component of himself or herself to another individual
2.

-Buproprian recommended fo SEASONAL AFFECTIVE DISorder

-Ketamine is a dissociative agent like PCP

-Low amount of Serotonin of CSF for violent criminals

-Monitor bulimic patients 2 hours after eating; to prevent purging of the meal

-ECT done by depolarization of cell membranes of neurons in rain sycnhoronoslyu

-Sensory gating is ability to sppreas information; people with schiziophrenia are often part of various
endophenotypes that process these stimuli abnormally wich may contribute to the disease.

-PARIETAL Lobe responsible for sensory integration and somatosensory function

-Medulla: Responsible for autonomic functions
-Occipital Lobe- Responsible for visual functions
-Frontal Lobe, Executive function, social conduct, judgment, insight and motor function

-Williams Syndrome: Patient often have elfin faces and starburst irises

-PAXIL AND ZOLOFT are the TWO meds approved foe the treatment of PTSD

-Atypical Antipsychotics have a class warning for increased mortality risk in elderly patients with dementia
related psychosis

-Lithium-> Ebstein Barre-> Tricuspid valve

-Bulimia and BPD

-Early onset Bipolar Disease is less responsive to Lithium

-FDA Approved meds for BIPOLAR depression for adolescents are lurasdidone and olanzapine/fluoxetine

-FDA approved meds for BIPOLAR MANIA: Abilify, Risperdal, Seroquel, olanzapine, asenapine
21
-NO FDA APPROVED Meds for BIPOLAR Disorder for children <10 years

-Plasma levels of Fluoxetine delayed, but not decreased when taken with food

-Thyroid problems may mimic psychiatric disorders in Down Syndrome Patients; hypothyroidism is common in
patients with down syndrome and can mimic depression

-ANC must be > 1,500 to initiate treatment with clozapine. Patients recover from agranulocytosis within 14-24
days after stopping the drug. Rechallenging clozapine not recommended if it falls below 1,000 due to high rate
of recurrence

-Prognosis of adolescents for adjustment disorder is more guarded than of adults as adolescents diagnosed with
it are more likelyt to develop major psychiatric illness than adults with adjustment disorder

-SSRI’s may increase risk of bleeding due to interactions with serotonergic receptors in platelets

-SIADH commonly occurs with fluoxetine***** CNS activation (anxiety, restlessness, tremor and insominia)
occurs most commonly with Fluioxetine too

-GI symptoms most common with sertraline and fluvoxamine

-Dilated pupils -> Opioid withdrawal -Pinpoint pupils -> Intoxication

-Anxiety disorder commonly occurs with Autism Spectrum Disorder

-Ativan is metabolized in the liver by the process of glucuronidation; doesn’t involve hepatic oxidation by the
cytochrome P450 enzymes and UNAFFECTED BY LIVER INJURY. Can be usewd for conditions with liver
injury; so can oxazepam and temazepam (OTL) Out the Liver

-SSRI’s assoc. with HYPONATRMIEA AND SIADH, particularly in elderly females

-Congenital adrenal hyperplasia linked with increased rates of homosexuality

-Ramelteon is MT1 and MT2 receptor AGONIST

-ECT FDA Approved for catatonia

-Vagus Nerve Stimulation is FDA indicated for treatment resistant depression in adults and refractory epilepsy

-In crossover studies, two groups eventually undergo the same treatment; may be in different order though

-Dopamine, SE and NE all play some role in social phobia; dopamine is thought o mediate social interest,
gregraiousness, confidence, sensitivity to rejection. People with low levels of DA in the CSF adnd Parkinson’s
disase are more likely ot be introverted an have social phobia as well

-Restrictive covenant contracs often include non-compete clauses that restrict an employee from practicing
withing a set number of miles from an employers business for a set period of time after the employee leaves the
business

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-OARS: open ended questions, affirmations, REFLECTIVE** listening (not reflexion), summaries

-Acromprosate structurally resembles GABA

-Zoloft is preferred SSRI for breastfeeding

-TCA’s can exacerbate cardiac arrhytmias, worsening of narrow angle glaucoma, constipation, confusion, BPH

-Lithium used for kleptromania

-ADHD and lead poisoning

-seasonal affective disorder and buproprion

-Lithium has Insulin Like Effect

-somatization disorder, hypochondriasis and pain dxorder are part of DSM IV, no longer used

-One of the most important things for IRB is to protect test subjects

-Drive for Satisfaction AND drive for security: IPT (Interpersonal Theory)

-CDT is most specific for ETOH misuse; GGT for chronic heavy use ETOH

-Valproic Acid FDA approved for mania for children 12 and OLDER

-Early onset Bipolar disorder is less responsive to lithium; so Lithium used adjuntively

FDA Approved for BIPOLAR MANIA for Adolescents: Lithium, Abilify, Risperdal, seorquel, Zyprexa,
asenapine
FDA approved for BIPOLAR DEPRSSSION in adolescents: Lurasidone and olanzapeine/fluoxeitine
NO FDA DRUGS FOR < 10 years for BIPOLAR

-Jean Baker Miller assoc. with relationship theory

-Modafinil approved DA for excessive sleepiness, sleep apnea, shift work disorder, fatigue in depression,
uhypersomnolence

-Depressed mood and eating disorder: Fluoxetine

-Wernicke’s Encephlopathy has foot weakness and foot drop; DT does not. Kosakaoff’s has amnesia,
confabulation

-Depression – Decresaed slow-wave and REM latency

-FDA approved meds for ETOH use Disorder: Naltrexone, Acamprosate, Disulfiriam
-OPIOID USE: Naltrexone, comorbid ETOH disorder

-Negative contrast: switched from high to low rewards, weaken behavior

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-Smoking (nicotine) casuse release of ADH which fuels thirst; high antipsychotic doses associataed with
polydipsia

-Olanzapine has risk for diabetic ketoacidosis

-Bromocriptine used for NMS; also dantrolene

-Fluvoxamine can increase Clozaril levels;

-Deontology is by Immaneual Kant, root of many religious traditions; holds that an action’s ethicality is based
on the intent behind the decisions

-Phentolamime used for malignant hypertension

-Clonidine is useful for treating autonimic effects of opiate withdrawal

-Paxil and Zoloft used for post-partum depression breast feeding; low to undetectable. Prozac and Celexa have
high presence in breast milk

-ASD, 1/100 affected

-Namenda, NMDA antagonist

-Avolition: LACK OF INTEREST AND DRIVE

-ABULIA: LACK OF WILLPOWER

-STEREOTYPIES are UNCHANGING

-ENZYME Inhibition is faster than induction

-DOPAMINE, ACH, NE can be more awakening.

-Adenosine Promotes Sleep

-Most Cases of Bipolar disorder start at 15-19, than 20-24 years of age

-CLOMIPRAMINE can be used for OCD

-AUDIC-C is a three item version of AUDIT; used to allow cooperation with a client who is acutely ill or
otherwise poorly disposed to speaking with a provider
-AUDIT (Alcohol Use Disorders Identification Test) 10 multiople choice questions regarding quantity and
frequency of a patient’s alcohol consumption, drinking behavior, and alcohol related problems: GOLD
STNADARD for SCREENING
-CAGE: CUT BACK; ANNOED: GUILTY; EYE OPENER; screening tool for sensitivity and specificity
-MAST: MICHICGAN ALCOHOL SCREENING TEST; 25 questions screening tool that have simple yesn and
no answers

-atomoxetine blocks reuptake of NE

-Advanced directives vary from state to state; must sign for each state

24
-Lithium for both bipolar mania and prophylaxis. Also antidepressant augmentation

-TCA: Convulsions and coma when toxic levels

-Quasi experimental design is like an experiemental design without random sampling

-Edinburgh depression scale is for screening in pregnancy and postpartum period

-Longterm inpatient psychiatric care involves a minimum of three months

-Elderly white men have greatest rrisk for suicide

-Anorexia is common with stimulants

-Avolition: THINK VOLVO, Drive and Interest

-ABULIA: Willpower and initiative

-schizophrenia invol ed with high I , higher socioeconomic status, high education achievement, high
sexpectations

-Schedule
I drugs
II opiates
III steroids,
IV Benzos
V Lomitil

-Wait 5 weeks after between ssri and maoi

-Remeron has least amount of sexual side effects compared to other antidepressants
-1500!!!!!!!!!!!!!!!!!!!!!!! WBC for clozapine

-Catatonia = ECT

-In outpatient setting 50% of children referred for depression are suicidal

-CHRONIC ETOH USE LEADS TO INDUCTION****** acute etoh use leads to inhibition

-Necrosis induced inflammatory response, apoptosis does not

-Fluvoxamine can increase clozapine levels when taken together

-OCD/and Tics and be assoc. with group A streptococcus

-Post-partum period increases risk for recurrence of bipolar disorder

-carbamezapine safe for breast feeding

-Inductive: observe something, make a conclusion

25
-Deductive: Make a prediction based on principles

-PCOS is a common side effect of Depakote; high risk for suicide in women

-Dextromethorphan can contribute to serotonin syndrome

-Cauliflower is an inducer

-Valproate Acid Loading Dose 20-30 mg/kg

-Topamax also used for ETOH maitnenence

-Id is selfish, Ego Logical, Superego consciousness (I should or ought)

26
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